Women caring for their own sexual and reproductive health is nothing new. For millennia, women have managed the normal functions of menstruation, contraception, pregnancy, and childbirth, in addition to combating illness for themselves and their families. What is new is the context in which women practice self-care and promote the health and well-being of their families.
While women of centuries past had to make do with traditional therapies (some of which were ineffective or harmful), today’s women and girls—including those in low-resource settings—have marked advantages. A greater recognition of women’s agency and rights, coupled with the increasing availability of improved tools, are maximizing women’s ability to safely and effectively care for their own health. International Women’s Day provides the perfect opportunity to reflect on a self-care approach to women’s health and how we can advance it.
Understanding the concept
Although women’s self-care has spanned the ages, the concept of self-care was only recognized by the World Health Organization (WHO) in the 1980s. WHO defined self-care as “the activities individuals, families, and communities undertake with the intention of enhancing health, preventing disease, limiting illness, and restoring health…undertaken by lay people on their own behalf… either separately or in participative collaboration with professionals.”
Another, perhaps simpler, way to think about the concept of sexual and reproductive health self-care is this: women and girls are able to identify their own health needs, to access appropriate health technologies, and to effectively manage their health conditions—including seeking health services and professional help when necessary.
Regardless of which definition is used, women will only be able to practice self-care if their autonomy, agency, and human rights are upheld. Any effort to empower women to take charge of their own sexual and reproductive health must also cultivate and elevate their voices and agency, and this point cannot be lost on policymakers and program managers.
Reaping the benefits
Women have the ability and the right to assess and manage their own sexual and reproductive health needs, and there are myriad improved tools and practices that make this possible. Encouraging, preparing, and supporting women to have greater control and decision-making in their sexual and reproductive health care creates multiple benefits not only for women themselves, but also potentially for health systems.
When a woman assesses and manages her own care, she has the opportunity to build “health assets.” In other words, she learns about her body, becomes more aware about her physical conditions, and increases her self-sufficiency to responsibly use products and services. This may also lead to better health outcomes. For example, research has demonstrated that when people are active participants in their own health, adherence to medication and treatment improves.
Women’s sexual and reproductive health self-care may also introduce advantages from a health systems perspective, especially in low-resource settings. In some ways, self-care is the ultimate form of “task-shifting”—where specific tasks are moved from higher to lower levels of system in order to make more efficient use of human resources for health. Except in this case, it is the woman who receives the training (if/as needed) and administers the intervention herself. This means that health workers are freed up to devote more time and resources to conditions that require medical intervention (like vaccinations or treating illnesses).
Accelerating self-care through new tools and channels
Exciting developments and an expanded array of user-centered sexual and reproductive health products and practices are being introduced and scaled up for use, enabling women and girls to have more active participation in their health. These products and practices include phone-based applications for predicting menstrual cycles, home pregnancy tests, pericoital “on-demand” contraception, contraceptive vaginal rings, contraceptive self-injection, medical abortion, HIV self-testing, and human papillomavirus DNA self-sampling. Evidence is growing that women can safely and effectively use these tools, and that they like them.
In addition, the proliferation of service-delivery outlets (including private-sector outlets like pharmacies and drug shops) and information channels (like social media and mobile phone applications) is offering women even greater possibilities for self-motivated, self-directed access to sexual and reproductive health products.
Realizing a self-care approach
Overall, there is good evidence of acceptability and feasibility across a spectrum of products and practices intended to promote sexual and reproductive health self-care. Health systems and practitioners can and should trust women with many aspects of their own care. Encouraging self-care can help women and girls build their health assets, make health care products and practices more accessible, and reinforce the internationally agreed upon human right to good health and self-determination.
Women’s self-care has come a long way and will continue to evolve. This International Women’s Day, a few places to help advance self-care include:
- Advocating for the importance of women’s autonomy in sexual and reproductive health care.
- Calling for further investment in developing and broadening access to self-care products for women.
- Advancing efforts to deepen women’s reproductive health literacy.
- Strengthening health systems to better respond to women’s needs and life circumstances.
- Martha Brady is the director of the Reproductive Health Program at PATH.